Medical Billing Blog: Section - Claims
Archive of all Articles in the Claims Section
This is the archive containing links to all articles written in the Claims section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
RCM tip: Invest in automated rules engine to improve RCM
Investing in automation tools, such as a rules engine, can help healthcare organizations decrease their administrative workload, according to Andrew Wade, practice administrator at Conway, S.C.-based Coastal Orthopedics. Mr. Wade shared the following tip with Becker’s Hospital Review: “If we want to truly free up providers from administrative burden and empower them to do the work they love to do — spending more time with patients and delivering quality care — organizations need to invest in tools that automate tasks wherever possible. Thanks to our technology’s rules engine, our claims can be automatically verified and some errors automatically resolved based on knowledge gleaned from the network. We are getting cleaner …
How to Choose Between Modifiers 25 and 57
When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains …
Indiana Makes Top 5 States for EHR Adoption
A recent report by the Center for Data Innovation ranked each state based on its rate of EHR adoption and provided recommendations on how policymakers can enable more efficient data use. Data innovation—specifically in the healthcare industry—is imperative to fostering improvements across the care continuum. Researchers at the Center for Data Innovation stated data insights using EHR technology for preventive care and better clinical decision making could cut costs across the industry by up to $450 billion. States were evaluated and ranked for their level of EHR adoption and use according to the availability of high value data sets, development of useful technologies, and proliferation of human and business capital …
RCM tip: Stop snail mail for electronic billing
Healthcare organizations should offer electronic billing options patients want rather than use snail mail to send paper statements, according to Jim Denny, president and CEO of Duluth, Ga.-based Navicure. He specifically cited a 2017 Patient Payment Check-Up survey that reveals 89 percent of providers still send paper statements through snail mail, although more than 50 percent of patients prefer electronic bills over paper statements. Given this survey, Mr. Denny shared the following tip with Becker’s Hospital Review. “Despite the abundance of technology that is available, many providers are still billing patients via snail mail. Not only does this way of billing cost more (on average paper billing can cost $7 …
EHR Dissatisfaction is Contributing to Provider Burnout
“I am a daily user of two EHR systems. One is a community hospital based complex EHR, and one is a cloud and iPad based EHR that we use in our private practice. The private practice-based EHR is much more user friendly and adapts well to our practice. I am what you would consider a “power-user” on our community hospital based EHR, and spend a fair amount of time helping other members of the medical staff better understand and use it. The integrated dictation, patient education, auto-population of data, and macros are just a few of the elements of the EHR that make my life easier, and has the potential …
